HomeMy WebLinkAboutCONSTRUCTION CONCEPTS - INSURANCE CERTIFICATE (3)ACOR_D.. CERTIFICATE OF LIABILITY INSURANCE OP ID KH DATE(MMIDD/YYYY)
CONST-1 06 09 O8
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Johnstown CO 80534
Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC#
Construction Concepts Inc.
Marc & Kim Dewey
14125 Mead Street
Longmont CO 80504
1�1�1�1a:I_lCl�.'1
INSURER A'. EMC Insurance Comp
INSURER B: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E.
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR' DD -.__ .. ...__ - __.__._. ____ __. __
-- ROCKY EFFECTIVE POLICY EXPIRATION
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MMIDD/1'Y LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$1000000
A
COMERCIALGENERAL LIABILITY
3X0-95-53
08/24/07
08/24/08
-DAMAGE TORENTEr—_.
_PREMISES (Eaoccurence)
$100000
�y �
MED EXP (Any one person)
_
$ 5000
AIM$MADE L'J OCCUR
1x4l'
ket Add'1 Ins
CG7482
PERSONAL& ADV INJURY
$1000000
Contractual Li.abi.
CG 00 01 10 01
.___...-----
GENERAL AGGREGATE
---__._....-------
$ 2000000
SENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
s2000000
POLICY ][ I PROECT LOC
J
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$1000000
A
ANY AUTO
3XO-95-53
08/24/07
08/24/08
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
$
X
SCHEDULED AUTOS
(Per person)
X
HIRED AUTOS
-
- ------
BODILYINJURY
$
X
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
(Per accitlent)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
-
OTHER THAN EA ACC
$
AUTO ONLY: AGG
b
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
s2,000,000
A
X OCCUR CLAIMS MADE
.__ __.
3XO-95-53
08/24/07
08/24/08
AGGREGATE
$2,000,000
DEDUCTIBLE
$
X RETENTION $10,000
$
WORKERS COMPENSATION AND
X TORY LIMITS X TI FF
ER
B
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
4031745
07/01/0$
07/01/09
---------------
E.L. EACH ACCIDENT
----
$1000QQQ
OFFICER/MEMBER EXCLUDED?
.......... ...
E.L. DISEASE - EA EMPLOYEE
$ ZOOOOOO
If yes, tlascribe antler
----------------
SPECIALPROVISIONSbelow
E.L. DISEASE -POLICY LIMIT
$1000QU0
OTHER
A
Property Section
3XO-95-53
08/24/07
08/24/08
Leased & 200,000
A [Equipment
Floate
RC ON LEASED & RENTPD
Rented
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: Bobcat Ridge House Rehabilitation & Primose Art Studio Remodel
City of Ft. Collins
215 N. Mason Street
Ft. Collins, CO 80524
FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $0 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
ACORD 25 (2001/08)
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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